The central role of cognitive processes in the perpetuation of chronic fatigue syndrome
ABSTRACT Chronic fatigue syndrome (CFS) is considered to be one of the functional somatic syndromes (FSS). Cognitions and behavior are thought to perpetuate the symptoms of CFS. Behavioral interventions based on the existing models of perpetuating factors are quite successful in reducing fatigue and disabilities. The evidence is reviewed that cognitive processes, particularly those that determine the perception of fatigue and its effect on behavior, play a central role in the maintenance of symptoms.
Findings from treatment studies suggest that cognitive factors mediate the positive effect of behavioral interventions on fatigue. Increased fitness or increased physical activity does not seem to mediate the treatment response. Additional evidence for the role of cognitive processes is found in studies comparing the subjective beliefs patients have of their functioning with their actual performance and in neurobiological research.
Three different cognitive processes may play a role in the perpetuation of CFS symptoms. The first is a general cognitive representation in which fatigue is perceived as something negative and aversive and CFS is seen as an illness that is difficult to influence. The second process involved is the focusing on fatigue. The third element is formed by specific dysfunctional beliefs about activity and fatigue.
- SourceAvailable from: Arno van Dam
- [Show abstract] [Hide abstract]
ABSTRACT: Burnout patients perform poorer on cognitive tasks than healthy controls. A possible explanation for this decreased performance is a relatively permanent reduced motivation to expend effort. In a previous study, we failed to enhance the performance of burnout patients using a monetary incentive and positive feedback. In an attempt to bypass cognitions about fatigue and performance, we tried to motivate healthy controls and burnout patients implicitly by priming participants with either success or failure prior to task performance. As expected, healthy controls primed with success outperformed healthy controls primed with failure. However, no differential priming effect was observed in burnout patients. This suggests that success priming fails to enhance performance in subjects with burnout.Psychology 08/2012; 3:583-589. DOI:10.4236/psych.2012.38087